Hypocalcaemia after Total Thyroidectomy, potentially a serious issue!

Abstract

Introduction: Hypocalcaemia is a common post thyroidectomy complication in addition to nerve   injuries   and   bleeding. The incidence is variable in   different   studies and   total thyroidectomy   has   higher   incidence than partial thyroidectomy. Objectives: To study the incidence of temporary and permanent hypocalcaemia and to review value of post-operative calcium level in predicting short and long term cases of hypoparathyroidism. Methods: This was a prospective study carried out at Zayed Military Hospital, Abu Dhabi from January 2007 to December 2011. A total of 105 cases were included in the study who underwent total thyroidectomy. Calcium levels at 6 and 24 hours operatively were recorded. Results:  Temporary hypocalcaemia of 25.7% patients and permanent hypocalcaemia of 3.8 % was noted. Calcium drop of less than 1 mg/dl from pre-operative level was not significant as all patients recovered without any symptoms. Calcium drop of more than 1.1 mg/dl needs close follow up. Females had slightly higher incidence of hypocalcaemia. Conclusion: Post thyroidectomy calcium is an easy and cost effective way to identify high risk cases which need close monitoring and treatment with vitamin D and calcium.